Race and Mortality Risk After Radiation Therapy in Men Treated With or Without Androgen-Suppression Therapy for Favorable-Risk Prostate Cancer

被引:13
作者
Kovtun, Konstantin A. [1 ]
Chen, Ming-Hui [2 ]
Braccioforte, Michelle H. [3 ]
Moran, Brian J. [3 ]
D'Amico, Anthony V. [4 ]
机构
[1] Brigham & Womens Hosp, Dana Farber Canc Inst, Harvard Radiat Oncol Program, 75 Francis St, Boston, MA 02115 USA
[2] Univ Connecticut, Dept Stat, Storrs, CT 06269 USA
[3] Prostate Canc Fdn Chicago, Westmont, IL USA
[4] Brigham & Womens Hosp, Dana Farber Canc Inst, Dept Radiat Oncol, 75 Francis St, Boston, MA 02115 USA
关键词
androgen-deprivation therapy; brachytherapy; mortality; prostate cancer; race; radiation therapy; RADICAL PROSTATECTOMY; DEPRIVATION THERAPY; FOLLOW-UP; RADIOTHERAPY; TRIAL;
D O I
10.1002/cncr.30224
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND: African American (AA) men are more likely than non-AA men to have a comorbid illness that could interact with androgen-deprivation therapy (ADT) and shorten survival. This study assessed the impact that race had on the risk of all-cause mortality (ACM) and other-cause mortality (OCM) among men definitively treated for favorable-risk prostate cancer (PC). METHODS: Between 1997 and 2013, 7252 men with low-risk or favorable intermediate-risk PC were treated with brachytherapy with neoadjuvant ADT (n = 1501) or without neoadjuvant ADT (n = 5751) for a 4-month median duration. Cox and Fine-Gray multivariate regressions were used to analyze whether the risk of ACM and OCM increased among AA men versus non-AA men receiving ADT; adjustments were made for the age at brachytherapy, year of brachytherapy, cardiometabolic comorbidity status, risk group, and ADT treatment propensity score. RESULTS: After a median follow-up of 8.04 years, 869 men (12.0%) died: 48 (5.52%) of PC and 821 (94.48%) of other causes. There was a significant association between AA race and an increased risk of both ACM (adjusted hazard ratio [AHR], 1.77; 95% confidence interval [CI], 1.06-2.94; P = .028) and OCM (AHR, 1.86; 95% CI, 1.08-3.19; P = .024) among AA men versus non-AA men who received ADT but not among those who did not receive ADT (AHR for ACM, 1.33; 95% CI, 0.93-1.91; P = .12; AHR for OCM, 1.39; 95% CI, 0.96-2.02; P = .08). CONCLUSIONS: ADT use may shorten survival in AA men with favorable-risk PC; therefore, its reservation for the treatment of higher risk PC, for which level 1 evidence supports its use, should be considered. (C) 2016 American Cancer Society.
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收藏
页码:3608 / 3614
页数:7
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